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Should I Get the Same Medicare Supplement Plan as My Spouse?

Medicare Supplement Plans are individual plans. Unlike your employer group insurance, where you may be able to add spouses and dependent children to your plan, Medicare Supplement Plans generally only cover the person who buys the plan.

That may be good news for spouses, who could have very different health care needs. If you and your spouse are shopping for Medicare Supplement Plans, here are some things to keep in mind before you buy.

What do Medicare Supplement Plans cover?

Although Medicare Supplement Plans are sold by private insurance companies, benefits are determined by the federal government. In other words, Plan A sold by Company X will have the same basic benefits as Plan A sold by Company Y.

Medicare Supplement Plans are designed to cover out-of-pocket costs, such as deductibles and copayments and/or coinsurance amounts, associated with Original Medicare. Each plan generally pays a different percentage and combination of costs.

All Medicare Supplement plans generally pay some or all of your Part A and Part B copayment and coinsurance amounts, your hospice coinsurance, and your first three pints of blood you get in a blood transfusion. Medicare Supplement Plans do not, however, cover any costs associated with Medicare Part D prescription drug coverage.

How should you choose Medicare Supplement Plans?

There are several factors each spouse should consider to help you decide which Medicare Supplement Plan is best for you:

  • Your health status

Although it may be difficult to predict your health care needs in the future, you can look at how you currently use health care, and if you have any serious or chronic health conditions that will require treatment for many months or years.

For example, if you’re fairly healthy and you only see the doctor for preventive care and the occasional minor illness or aches and pains, you may be happy with more basic Medicare Supplement Plans such as Plan A, which covers your Part A coinsurance for inpatient hospitalization and hospice care, as well as your Part B coinsurance.

On the other hand, if you use a lot of health care every year, or you have a condition such as heart disease or diabetes that requires regular monitoring and supervision, you may want a more comprehensive plan, such as Plan C or Plan F that may cover the majority of your out-of-pocket health care costs under Original Medicare. (You will generally need to get additional coverage for prescription drugs.)

  • Your budget

Medicare Supplement Plans with more comprehensive coverage may cost more than plans with basic benefits. However, if you are on a fixed income and need predictable health care expenses to make your budget work, it may be worth it to you to pay more up front for a comprehensive plan knowing that your medical bills will be covered.

You may also be able to save money with high-deductible Plan F, which has fairly comprehensive benefits, but also an annual deductible. With this Medicare Supplement plan, you pay a deductible of $2,300 before your plan pays anything.

  • Your lifestyle

Although Medicare doesn’t generally cover any health care costs when you’re traveling outside the U.S., there are Medicare Supplement Plans that cover emergency care in foreign countries. If you travel abroad a lot, this coverage might matter to you.

What else should my spouse and I consider when shopping for Medicare Supplement Plans?

Because benefits are standardized by plan, it’s a good idea to comparison shop for the lowest premiums on comparable plans once you know which plan you and your spouse want to buy. You should also check the quality and consumer reviews of any company selling the Medicare Supplement Plans you’re interested in.

If you and your spouse want coverage with Medicare Supplement Plans, don’t wait to buy. You generally have guaranteed issue rights for six months when you first become eligible, which means you can buy any Medicare Supplement Plan sold in your state, and you generally can’t be turned down or charged more for your plan due to a health condition.

To find out more about Medicare Part D plans in your area, enter your zip code on this page.

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